Although the Wnt signal pathway was first determined in terms of developmental pathways during embryogenesis, further research has established that it continues to be a factor in adults as well. Consequently, increased or decreased levels of activity of various members of the Wnt pathway have been associated with a number of different disease conditions. For reviews on the relationship between the Wnt pathway and disease see Moon et al., 2004 Nature Rev. Genet. 5; 691-701, Manolagas and Almeida, 2005 Molec. Endrocrin. 21; 2605-2614, Johnson and Rajamannan, 2006 Rev. Endocr. Metab. Disord. 7; 41-49, Luo et al., 2007 Lab. Invest. 87; 97-103, Maiese et al., 2008 Pharmacology & Therapeutics 118; 58-81. As discussed in these reviews, diseases that have been associated with Wnt pathway elements include cancer, diabetes, osteoporosis, neurodegenerative diseases such as Alzheimers as well as vascular disease and cardiac dysfunction. Although these diseases are very disparate in terms of the nature of their pathologies, they are united in having one or more members of the Wnt signal pathway involved in the disease. The role of the Wnt signaling system is best known for its significance in cancer. However, there are other diseases involving Wnt that are of tremendous importance to healthcare. For example, diabetes is a disease whose prevalence is experiencing tremendous growth worldwide. While an increased life span may account for part of this growth, other factors such as diet, lifestyle and environment also likely play significant roles. Regardless of the causative agents, it was estimated that there were 16 million affected individuals in the United States alone and 171 million cases of diabetes worldwide in 2000; in addition there was an expectation that the latter number would rise to 366 million people in 2030 (Wild et al., 2000 Diabetes Care 27; 1047-1053).
One of the members of the Wnt signaling system, low density lipoprotein receptor-related protein 5 (LRP5), was initially isolated and characterized (Hey et al., 1998 Gene 216; 103-111) due to its proximity to IDDM4, a putative marker for diabetes. Expression patterns of LRP5 in macrophages, Vitamin A system cells and Islets of Langerhorns reinforced the idea of connectivity between LRP5 and diabetes (Figueroa 2000 J. Histochem. Cytochem. 48; 1357-1368). When low density lipoprotein receptor-related protein 6 (LRP6) was identified soon after, it was postulated that due the similarity with LRP5, it might also be involved in diabetes (Brown et al., 1998 Biochem. Biophys. Res. Commun. 248; 879-888). It was only later that LRP5 and LRP6 were recognized as being involved in the Wnt signaling system (Tamai et al., 2004 Nature 407; 530-535, Pinson et al., 2004 Nature 407; 535-538). Subsequently, Fujino et al. (2003 Proc. Nat. Acad. Sci. (USA) 100; 229-234) investigated the metabolic consequences of a genetic ablation of LRP5 and concluded that LRP5 is essential for both normal cholesterol metabolism and glucose-induced insulin secretion. The presence of an LRP5 deficiency in either homozygous (LRP5−/−) or even heterozygous (LRP5+/−) mice resulted in a significant increase in plasma cholesterol levels when the animals were fed a high-fat diet. Although fasted blood glucose and insulin levels were normal in the mutant strains, they showed a defect in glucose tolerance when challenged. These animals also showed impaired clearance of chylomicron remnants and also impaired glucose-induced insulin secretion from the pancreatic islets. The effect of a lack of LRP5 was also tested in a double mutation situation where the mice lacked not only LRP5, but also apoE (Magoori et al. 2003). Although neither condition alone led to changes in cholesterol levels with a normal diet, the double condition led to 60% higher plasma cholesterol levels. At 6 months of age, the double-null mice had also developed severe atherosclerotic lesions that were three times larger than those in knockout mice missing only apoE. The connection between LRP molecules and metabolism is also evidenced by the discovery that certain polymorphisms in the LRP5 gene have been correlated with obesity phenotypes in a family based study (Guo et al., 2006 J. Med. Genet. 43; 798-803) and intronic variants of LRP5 have been associated with obesity. Lastly, a mutation in LRP6 has been correlated to an autosomal dominant defect that results in the expression of phenotypic features associated with metabolic syndrome: hyperlipidemia, hypertension and diabetes (Mani et al., 2007 Science 315; 1278-1282. Other members of the Wnt signaling system such as TC7FL2 (also known as TCF-4) have also been associated with a risk for the development of diabetes (Jin and Liu 2008 Molec. Endocrin. 22; 2383-2392).
Reflecting its role in bone development during embryogenesis, the Wnt pathway continues to be involved in osteogenic processes such as healing of bone as well as bone degeneration diseases such as osteoporosis. Osteoporosis is a major public health problem, and it is especially prevalent in aging populations (NIH Consensus Conference Development Panel on Osteoporosis Prevention 2001 JAMA 285; 785-795, Kannus et al., 2000 Osteporos. Int. 11; 443-448, Lips 1997 μm. J. Chem. Med. 103; 35-85). The majority of fractures that occur in people over the age of 65 are due to osteoporosis (Kannus 2000, Zuckerman 1996 N. Eng. J. Med. 334; 1519-1525). Peak bone mass is a determining factor in establishing the risk of osteoporotic fracture (Heaney et al., 2000 Osteoporos. Int. 11; 985-1009), and studies indicate that genetic factors contribute significantly to the variance in peak bone mass.
One of the genes that regulate bone mass has recently been identified via positional cloning. Loss of function mutations in LRP5, a co-receptor for the canonical Wnt signaling pathway (Nusse 2001 Nature 411; 255-256), were found to be associated with Osteoporosis-Pseudoglioma Syndrome (OPPG), an autosomal recessive disorder which shows a reduction of bone density in humans (Gong et al., 2001 Cell 107; 513-523). In addition, two independent kindreds that manifest familial High Bone Mass (HBM) phenotypes were found to harbor a Gly171 to Val substitution mutation (G171V) in LRP5 (Boyden et al., 2002 New. Engl. J. Med. 346; 1513-1521, Little et al., 2002 μm. J. Hum. Genet. 70; 11-18). More recently, additional HBM mutations were reported in the same structural domain of the G171V mutation (van Wesenbeeck et al., 2003 μm. J. Hum. Genet. 72; 763-771). Moreover, mice in which the LRP5 genes were inactivated by gene targeting showed phenotypes similar to those of OPPG patients (Kato et al., 2002 J. Cell Biol. 103; 303-314), and transgenic expression of LRP5G171V in mice resulted in HBM (Babij et al., 2003 J. Bone Res. 18; 960-974). Furthermore, mouse primary osteoblasts showed reduced responsiveness to Wnt in the absence of LRP5 (Kato et al., 2002), while Wnt (Gong et al., 2001) or activated beta-catenin (Bain et al., 2003 Biochem. Biophys. Res. Commun. 301; 84-91) stimulated the canonical Wnt signaling activity and induced the production of the osteoblast marker alkaline phosphatase (AP) in osteoblast-like cells. Together, these pieces of evidence indicate that the canonical Wnt signaling pathway plays an important role in the regulation of bone development.
Wnt
The Wnt family of secretory glycoproteins is one of the major families of developmentally important signaling molecules and has been shown to regulate a wide range of biological and pathophysiological processes that include glucose metabolism, bone remodeling, adipogenesis, neurogenesis, stem cell biology, and tumorigenesis. Until recently, the canonical Wnt signaling pathway was believed to start when Wnt bound to Frizzled (Fz) proteins. The seven transmembrane domain-containing Fz proteins suppress the Glycogen synthase kinase 3 (GSK3)-dependent phosphorylation of beta-catenin through ill-defined mechanisms involving Disheveled proteins. This suppression leads to the stabilization of beta-catenin. In turn, beta-catenin may then interact with transcription regulators, including lymphoid enhancing factor-1 (LEF-1) and T cell factors (TCF), to activate gene transcription (Dale, 1998 Biochem. J. 329; 209-223, Gumbiner et al., 1998 Curr. Opin. Genetics Devel. 8; 430-435, Wodarz and Nusse, 1998 Annu. Rev. Cell Dev. 14; 59-88). Recently, genetic and biochemical studies have provided solid evidence to indicate that co-receptors are required for canonical Wnt signaling in addition to Fz proteins (Nusse, 2001, Pandur and Kuhl, 2001 Bioessays 23; 207-210). The fly ortholog of LRP5 or LRP6, Arrow, was found to be required for the signaling of Wg, the fly ortholog of Wnt-1 (Wehri et al., 2000 Nature 407; 527-530). LRP5 and LRP6 are close homologues which basically function the same way, yet exhibit different expression patterns. In addition, LRP6 was found to bind to Wnt1 and regulate Wnt-induced developmental processes in Xenopus embryos (Tamai et al., 2000 Nature 407; 530-535). Moreover, mice lacking LRP6 exhibited developmental defects that are similar to those caused by deficiencies in various Wnt proteins (Pinson et al., Nature 407; 535-538). Furthermore, LRP5, LRP6 and Arrow were found to be involved in transducing the canonical Wnt signals by binding Axin and leading to Axin degradation and beta-catenin stabilization (Mao et al., 2001 Mol. Cell. 7; 801-809, Tolwinski et al., 2003 Dev. Cell 4; 407-418). The LRP5 or LRP6-mediated signaling process does not appear to depend on Dishevelled proteins (Li et al., 2002 J. Biol. Chem. 277; 5977-5981, Schweizer and Varmus 2003 BMC Cell Biol. 4; 4). In addition, a chaperon protein, Mesd, was identified as required for LRP5 or LRP6 transport to the cell surface (Culi et al., 2003, Cell 112; 343-354, Hsieh et al., 2003 Cell 112; 355-367).
As expected for such an important signaling pathway, the Wnt pathway is subject to a number of controls on the expression and activity of various components of this system. Examples of naturally occurring antagonists include the Dickkopf (Dkk) family of polypeptides, Sclerostin, WISE and sFRPs. Contrariwise, activators of Wnt activity have also been described such as R-Spondin, Norrin and Casein Kinase 1ε.
The involvement of the Wnt pathway in inducing repression or expansion of bone growth was demonstrated in a number of publications that described the various effects of mutations in LRP5 upon skeletal structures that served to give rise to low bone mass (Gong et al., 2001, Streeten et al., 2006 J. Bone Miner. Res. 21; 1433-1442) or increased bone mass (Little et al. 2002, Boyden et al., 2002, van Wesenbeeck et al., 2003). There is even a genetically modified mouse model for osteoporosis, where disruption in both chromosomal copies of LRP5 (a LRP5−/− knockout) generates a low bone mass phenotype (Kato et al. 2002). However, it should be noted that even though the above mentioned references are in regard to LRP5, it should be obvious that intervention in other points along the Wnt signaling pathway could also benefit from administration of compound that have been identified through the processes of the present invention. For recent reviews of the interconnections between the Wnt pathway and bone growth, see cited references Johnson et al., 2004 J. Bone Miner. Res. 19; 1749-1757, Krane 2005 J. Exp. Med. 201; 841-843, Krishnan et al., 2006 J. Clin. Invest. 116; 1202-1209.
LRP5/6
LRP5 and LRP6 are commonly referred to as LRP5/6 in the literature due to a number of shared features-how they are involved in the canonical Wnt system and the sharing of a 70% homology on the amino acid level. As discussed above, LRP5/6 have been identified as co-receptors for Wnt with the various domains of the LRP5/6 proteins likely serving different functions in signal transduction. As described in related U.S. patent application Ser. No. 10/849,067, prediction of the structure of LRP5/6 has allowed the identification of molecules that may bind to YWTD repeat domain III through a virtual screening process followed by verification with biological assays on Wnt activity. A further series of molecules were tested and identified using these processes in related U.S. patent application Ser. No. 11/598,916. Effects that may be tested as being affected by such binding agents may be effects on Wnt signaling itself or effects based on influencing other proteins that are known to interact with LRP5/6. Examples of the latter are effects on repressors of Wnt signaling such as Dkk and Sclerostin.
Control of Wnt Activity
As expected for such an important signaling pathway, the Wnt pathway is subject to a number of controls on the expression and activity of various components of this system. Examples of naturally occurring antagonists include the Dickkopf (Dkk) family of polypeptides, Sclerostin, WIF-1, WISE and sFRPs. In contrast, activators of Wnt activity have also been described such as R-Spondin, Norrin and Casein Kinase 1ε.
Dkk
Dickkopf (Dkk-1) was initially discovered as a Wnt antagonist in Xenopus which plays an important role in head formation during embryogenesis. Thus far, four members of Dkk have been identified in mammals: Dkk1, Dkk2, Dkk3 and Dkk4 (for a review, see Niehrs 2006 Oncogene 25; 7469-7481). Dkk1 and Dkk2 are believed to inhibit canonical Wnt signaling by simultaneously binding to LRP5 or LRP6 and a single transmembrane protein Kremen. It has also been reported that the LRP5 HBM G171V mutation described above appears to attenuate Dkk1-mediated antagonism to the canonical Wnt signaling. The third YWTD repeat domain of LRP5 have previously been identified as being required for Dkk-mediated antagonism of Wnt signaling (Zhang et al., 2004 Mol. Cell. Biol. 24 4677-4684). In addition, the Dkk-binding cavity and key residues within the cavity have been delineated by site-directed mutagenesis (see related pending U.S. patent application Ser. No. 10/849,067). This cavity is located at the large opening of the barrel-like structure of the YWTD repeat domain that is made of six beta-propellers. Importantly, the two most important residues in the interaction with Dkk, residues Glu721 and Trp780 are located at the bottom of this cavity in the third YWTD domain, suggesting that small molecules that bind to this cavity may be able to disrupt the Dkk-LRP5 interaction by blocking the access to this key residue. Accordingly, as disclosed in related U.S. patent application Ser. No. 10/849,067, a library of compounds was used in a virtual screening process using the structure of LRP5 in conjunction with key residues to estimate binding abilities. A number of different compounds were identified by this process and later shown to have effects upon Wnt activity.
It is expected that many of the compounds that were selected for an ability to bind to LRP5 should also be able to interact with the LRP6 receptor as well, due to the high level of similarity noted above. In general, the areas comprising the YWTD repeat domains of the LRP5 or LRP6 receptor share sufficient amino acid homology with each other that similar structures are formed by each of these domains, but they are dissimilar enough that they vary in some of the dimensions of the pockets formed and have differences in some of the amino acids that are likely to be important in protein/protein interactions. Although predictions of the structure of Dkk have been described previously from the amino acid sequence (Aravind and Koonin 1998 Current Biology 8; R477-R478), this is only a rough estimate of the particular shape that Dkk assumes in its natural state. A purified active preparation of the carboxy CRD domain of Dkk1 was used to obtain precise physical measurements through NMR (Chen et al., 2008 JBC 283; 23,364-23,370) and it was verified that Dkk1 has some physical similarity to colipase. However, the NMR study determined the special positions of the amino acids in a more precise manner, and this structure was used in combination with information from mutagenesis studies to predict the nature of a complex formed between Dkk1 and LRP5/6. As expected, the most stable complex was formed between Dkk1 and the third YWTD domain. The binding of Dkk1 to the other domains (first and second) was capable of occurring but with lower affinities.
The exact mechanism of how Dkk binding to LRP5/6 leads to inhibition of Wnt activity is unclear. One of the earlier studies on the relationship between Dkk and LRP has described the binding of LRP5/6 with Dkk and Kremen resulting in the formation of a complex that undergoes rapid endocytosis thereby decreasing the amount of functional LRP5/6 on the cell surface (Mao et al., 2002 Nature 417; 664-667). Although this provided a potentially simple explanation for Dkk inhibition, more recent studies (Wang et al., 2008 JBC 283; 23,371-23,375) have shown that a dependency upon Kremen for Dkk inhibition was only seen under artificial conditions where both Kremen and LRP6 were overexpressed. Under more normal conditions it was found that even mutants that had lost an ability to bind Kremen were still able to inhibit Wnt activity. Another study examined endogenous levels of LRP6 and showed that treatment with Dkk1 did not lead to LRP down-regulation from the cell surface or affected the rate of internalization of LRP6 (Semenov et al., 2008 JBC 283; 21,427-21,432). Together, these suggest that in addition to LRP removal, a more direct mechanism is involved in Dkk inhibition of Wnt activity.
Other Wnt Inhibitors
In common with Dkk, there are other inhibitors of Wnt activity that may bind to LRP5/6. For instance, a Wnt antagonist called WISE (Itasaki et al., 2003 Development 130; 4295-4305) appears to be a context-dependent regulator of Wnt signaling; it may inhibit or stimulate Wnt signaling in different assays in Xenopus. WISE was also shown to bind to LRP6 and compete with Wnt8 for binding to LRP6. WISE shares 38% amino acid identity with Sclerostin, the gene product of the SOST gene. Loss of function mutations of SOST are responsible for an autosomal recessive Sclerostin skeletal disorder. Previous studies have shown that Sclerostin was highly expressed in osteocytes and that it might act as a bone morphogenetic protein (BMP) antagonist, but another study suggested that Sclerostin might not be a functional BMP antagonist and speculated that it might modulate Wnt signaling. Recently, the relationship with Wnt has been clarified by the discovery that Sclerostin binds to LRP5/6 (Li et al., 2005 J. Biol. Chem. 280; 19,883-19,887, Semenov et al., J. Biol. Chem. 280; 26,770-26,775, Ellies et al., 2006 J. Bone Mineral Research). More interestingly, it has been found that Sclerostin most likely binds to the YWTD domains I and II of LRP5/6 (Li et al., 2005). In line with this, it has been disclosed in related U.S. patent application Ser. No. 11/084,668 that compounds initially identified as being able to disrupt interactions between Dkk and LRP5/6 through binding to a YWTD repeat of LRP5/6 are also efficacious at interfering binding between Sclerostin and LRP5/6, as judged both by Wnt dependent assays as well as direct binding studies with an AlkPhos/Sclerostin fusion protein. Although not tested, a similar effect may also possibly be found for Connective-Tissue Growth Factor (CTGF), a Wnt inhibitor that also binds to these regions on LRP5/6 (Mercurio et al., 2004 Development 131; 2137-2147).
Another category of Wnt inhibitors acts more directly by binding to Wnt proteins themselves. For instance, the sFRP family (secreted Frizzled related protein) consists of a series of proteins resembling the Frizzled receptor. While these proteins retain the ability to interact with members of the Wnt family, they are incapable of transmitting the transmembrane signal carried out by Frizzled since they are secreted proteins (Finch et al., 1997 Proc. Nat. Acad. Sci. USA 94; 6770-6775, Leyns et al., 1997 Cell 88; 747-756; Uren et al., 2000 J. Biol. Chem. 275; 4374-4382). As such, they may compete with Frizzled for binding of Wnt molecules and function as competitive inhibitors. It has also been shown that sFRP may bind directly to Frizzled, thereby forming non-functional complexes which may also result in attenuation of Wnt signal (Wang et al., 1987 Cell 88; 757-766; Bafico et al., 1999 J. Biol. Chem. 274; 16,180-16,187). In either case, sFRPs may act by preventing binding of Wnt to its receptor. Other such proteins are WIF-1 (Hsieh et al., 1999 Nature 398; 431-436) and Cerberus (Piccolo 1999, Nature 397; 707-710) both of which also seem to function by preventing Wnt from binding to Frizzled.
Wnt Activators
As expected with such a sophisticated system, proteins have also been identified that act as activators of the Wnt system, including R-Spondin, Norrin and Casein Kinase 1ε. R-Spondin (Kazanskaya et al., 2004 Developmental Cell 7; 525-534; Kim et al, 2006 Cell Cycle 5; 23-26) has been shown to stimulate Wnt activity. Further research has shown that there are four different forms of R-Spondin in the mammalian cell, each of which is capable of stimulating Wnt activity, although at different levels, with RSpo2+RSpo3>RSpo1>RSpo4 (Kim et al., 2008 Mol. Biol. Cell 19; 2588-2596). Although R-Spondin is regarded as an activator of the Wnt pathway, it is not a substitute for Wnt since it requires the presence of Wnt for its activity (Binnerts et al., 2007 Proc. Nat. Acad. Sci. (USA) 104; 14,700-14,705). It therefore enhances the ability of Wnt to generate a signal. A potential mechanism for the synergistic action of R-Spondin has been postulated with regard to the internalization of LRP receptors after Dkk binding, where the presence of R-Spondin has been shown to reduce the extent of this process (Binnerts et al., 2007). However, this mechanism is still a matter of controversy as some groups claim that there is direct binding of R-Spondin to LRP receptors (Nam et al., 2006 JBC 281; 13,247-13,257 and Wei et al., 2007 JBC 282; 15,903-15,911), whereas other groups believe it is an indirect effect of binding through Kremen rather than LRP itself (Binnerts et al., 2007). However, similar to the effects with Dkk, Wnt activity in the presence of R-Spondin may also be suppressed by Sclerostin, a protein that is not known to involve interaction with Kremen. R-Spondin is believed to interact with Frizzled as well (Nam 2006, Wei 2007).
Another activator of the Wnt system was discovered through studies of a congenital blindness defect, Norrie Disease (pseudoglioma), where it was found to be due to mutations linked to a protein of unknown function, which was named “Norrie Disease Protein” or “Norrin” (Berger et al., 1992 Nat. Genet. 1; 199-203; Chen et al., 1992 Nat. Genet. 204-208). Subsequent work has shown that Norrin is involved in the Wnt signaling system (Xu et al., 2004 Cell 116; 883-895) and more specifically linked to binding to the CRD portion of the Frizzled receptor, Norrin seems to function as a Wnt analogue requiring both Frizzled and LRP5/6 for activation of the Wnt pathway (Xu et al, 2004) even though it is unrelated to the Wnt family. A high level of specificity is seen where Norrin binds to Frz-4 but none of the other 14 mammalian Frizzled and sFRP CRD domains (Smallwood et al., J. Biol. Chem. 282 4057-4068). Interestingly, Bex and Bhat (U.S. Patent Application No. 20070196872 published Aug. 23, 2007) showed that after transfection with Norrin, LRP5 and Fz4 plasmids, Wnt reporter activity could be suppressed if Dkk was added as well, indicating that Wnt activity derived from Norrin activation was still susceptible to Dkk binding to LRP5.
Another activator of the Wnt system is Casein Kinase 1ε (Peters et al., 1999 Nature 401; 345-350; Sakanaka et al., 1999 Proc. Nat. Acad. Sci. USA 96; 12,548-12,552). This activator is involved in a complex series of reactions. For instance, there is an interaction between Casein Kinase 1ε (CK-1ε) and Wnt—the addition of Wnt leads to activation of CK-1ε and withdrawal of Wnt leads to inactivation of CK-1ε (Swiatek et al., 2004 J. Biol. Chem. 279; 13,011-13,017). In addition, it has been noted that CK-1ε binds to LRP5/6 and phosphorylates LRP5/6 in at least three different sites, events that might lead to increased activity (Swiatek et al., 2006 J. Biol. Chem. 281; 12,231-12,241).
Also, a recent development has shown that a complex formed between Parathyroid Hormone (PTH) and its receptor (PTH1R) may bind to LRP6 and stimulate Wnt activity (Wan et al., 2008 Genes & Development 22; 2968-2979). Although it was not tested in this study, it is likely that a related protein, Parathyroid Hormone related Peptide (PTHrP), may also induce this effect since it is similar to PTH and binds to the same receptor. This stimulation may be similar to that of Norrin in that it didn't seem to require the addition of exogenous Wnt to provide a substantial boost in the TCF/LEF reporter activity.
As described previously in related pending U.S. patent application Ser. No. 10/849,067, knowledge of the structure of a protein involved in a protein-protein interaction allows for a virtual screening for molecules that may interfere with that interaction by binding to a “hot spot” involved in the interaction, thereby potentially affecting the Wnt signal system. Also, as described in related pending U.S. patent application Ser. No. 11/598,916, identification of a molecule that binds to such a locus on a Wnt related protein may also have utility when the target protein has functions outside of the Wnt pathway as well.
Virtual screening programs used for this purpose enjoy scale versatility that extends from small molecules to macromolecules. For instance, amino acids, oligopeptides, polypeptides and intact proteins may all be evaluated in terms of their ability to be “docked” onto a site of a target protein. For example, as was discussed above, the determination of the structure of the Dkk CRD domain allowed a prediction for the structure of a complex between Dkk and LRP as well as evaluations of binding of Dkk to the various YVVTD domains of LRP5/6. Thus, the only limitation of a candidate molecule being screened for an ability to bind to a target molecule is solely based on the availability of its structure and the computational power devoted to the analysis. As such, as described in these applications, a wide variety of material may be used as a source of a virtual library including small molecules, cyclic molecules, heterocyclic organic molecules, lipids, charged lipids, polar lipids, non-polar lipids, sugars, glycolipids, peptides, oligopeptides, polypeptides, proteins, glycoproteins, lipoproteins, nucleic acids, chemical, as well as fragments or analogues of the foregoing. Examples of small molecules that may bind to the Dkk binding site of LRP5/6 and affect Wnt signaling are disclosed in related pending U.S. patent application Ser. Nos. 10/849,067, 11/084,668 and 11/598,916. A similar study was undertaken with regard to Dishevelled, another member of the Wnt signal pathway in related pending U.S. patent application Ser. No. 11/097,518 where a small molecule that was essentially a peptide analogue with substitution of two ether bonds in place of two peptide bonds was selected by a virtual screening process for binding to the PDZ domain of Dishevelled and later shown to block Wnt signaling.
One of the consequences of the identification of molecules that may affect Wnt activity is their potential role in the treatment of diabetes and other metabolic diseases, since it has been noted that increasing Wnt activity has positive effects upon glucose metabolism. For instance, animals that have genetic modifications such that they overexpress Wnt10b may be challenged with high fat diets and show a reduced level of triglycerides, a lower bodyweight, hyperinsulinemia and improved glucose homeostasis compared to their normal counterparts (Aslanidi et al., 2007). Administration of Wnt proteins may also be undertaken in vivo and show effects on glucose metabolism. For instance, experiments with ob/ob and agouti mice have shown that exogenous Wnt 10b may provide glucose tolerance and an increased sensitivity to insulin (Wright et al. 2007 Diabetes 56; 295-303). Wnt protein may also offer cells a protection from apoptosis derived from high glucose levels (Lin et al. 2006, J. Am. Soc. Nephrol. 17; 2812-2820, Chong et al., 2007 Curr. Neourovasc. Rev. 4; 194-204). Interaction of Wnt signaling with cholesterol metabolism has also been seen in studies where cholesterol levels were artificially depleted resulting in activation of the Wnt pathway signaling system and induction of myogenic differentiation (Mermelstein et al. 2007 Differentiation 75; 184-192; Portilho et al., 2007 FEBS Letters 581; 5787-5795).
As discussed above, in previous related pending applications we have described the use of virtual screening to identify non-naturally occurring molecules that could be used to artificially manipulate the effects of protein/protein interactions in the Wnt signaling system as well as protein interactions that may not be involved with Wnt but do interact with the LRP family. The application of small molecules that have been previously demonstrated to increase Wnt activity are in concordance with the diabetes results discussed above. For instance, Example 13 of related pending U.S. patent application Ser. No. 11/598,916 demonstrated that when compounds which were identified by virtual screening were tested with mice on a high caloric intake, they were able to affect glucose metabolism by: (a) decreasing the glucose levels to almost normal levels (IC15, IIIC3 and M01); (b) decreasing serum triglyceride levels (IC15 and M01); and (c) even decreasing serum cholesterol levels (M01). A further discovery was that when one of these compounds (IIIC3) was tested in a diabetic model (the db/db mouse), it was also able to show a significant drop in plasma insulin levels as well as a better response in a glucose tolerance test. The connection between Wnt pathway elements and sugar metabolism was also found in studies of mice lacking one or both copies of Dkk2: the double (Dkk−/Dkk−) mutant had much lower fasting glucose levels compared to the wildtype mice (Dkk+/Dkk+) and the heterozygous mice (Dkk+/Dkk−) had levels that were intermediate between the double mutant and wild type strains (Example 6 of related pending U.S. patent application Ser. No. 12/221,863). Thus it appears that a characteristic of pharmacological agents that have been discovered to raise Wnt activity is the potential utility in treatment of conditions such as diabetes.